need EM rotation with great teaching

[mfrederi]

I was hoping somebody would have had some experience with an EM rotation with really good didactics for the rotating med students. Especially some place that does some workshops on procedures (e.g. suture workshop, tubing workshop). I feel like I haven't learned really anything this year in the way of procedures (except a bunch of suturing in surg, but I still feel like I am way too slow), and don't want to fall flat on my face next year in my rotations. I have already done the biggest two procedure oriented rotations - IM, surg; without any real action.

thanks

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[Dr.Evil1]

I would suggest anesthesia as a great way to get airway experience on real patients. They usually also teach you how to do some invasive monitoring by putting A-lines or swan's in too (especially for cardiac surgeries).

 

[plank]

I strongly suggest the George Washington wound management elective. You have three full days of didactics with "advanced" suturing workshops, then you work 3 12-hour shifts per week (approximately). When you work, you are only in fast track, and you only have to see the patients that need procedures. Most of your teaching comes from PAs, but these are PAs that are specially trained in wound management. They definitely know their stuff better than lots of attendings. At the end, I felt very comfortable with a variety of nerve blocks, extensive suturing (especially of hands and face, including a good amount of intradermal suturing), splinting, I&Ds/paronychias, and a couple of joint taps. Most people don't really enjoy working in fast track, but when you're a student, and you can turn down the "Chief complaint: 2 years of back pain" patient, you will immediately fall in love with it.

As far as airway goes, I totally agree with Dr. Evil - do an anesthesiology elective.

If you want other, more basic things, like blood draws, IVs, ABGs, NGs, do an ER elective at a county hospital. If you're lucky, and you do it late enough in the year that the interns aren't hogging all the procedures, you may get an LP or two or a chest tube.

 

[Dr.MISHKA D.O.]

I found that Resurrection in Chicago was a very (VERY) good rotation for didactics (Residents and Attendings wicked smart) and procedures; tubed a ton of people, more suturing/stapling than I wanted, did 2 LP's, Reduced 5 dislocations, and countless I+D's, Splints, IV's, ABG's, and Foley's.

Came to Chicago a boy left a man. Great rotation.

The Mish

 

[FoughtFyr]

Mayo has a strong lecture core and LOTS of procedures.

- H

 

[mfrederi]

thanks guys, great advice

 

[pinbor1]

thanks guys, great advice

I would recommend the Mercy Hospital Emergency Medicine Rotation at UIC specifically. There is a great amount of clinical teaching there, you are responsible for you own patients, and will tube your patient if they need it, put in lines, suture, do I & Ds, reductions, splints, LP, etc. From what MishkaDO describes it sounds like resurrection is similar. When I was a med student way back, I put in ~3 central lines, 1 intubation, a couple LP's, tons of sutures and reductions. As a senior resident, I have pawned off a large number of my procedures there to junior residents, interns, and medical students depending on who is working the shift with me. Didactics are plus minus at times as the teaching alternates between UIC/Mercy/Illinois Masonic, it can be hard to coordinate schedule at times. At Mercy you tend to do a lot of workshops, at masonic more u/s education and at UIH it is pretty variable usually it consists of discussions regarding applications during the first part of the year.

As a 4th year medical student, I also did my rotation at Hennepin, which was an awesome experience. The only down side was there tended to be limited attending-student interaction because you staffed the majority of patients with the pit boss (senior resident). Procedures were limited as sick patients were taken care of in the stab rooms. As a student, you were limited to charting as a resident you had the oppurtunity for procedures. It's and excellent place to train and was my number 2 choice. Didactics were pretty good, the best part was the procedure workshop. There you had the chance to practice difficult airway techniques, do thoracostomies and thoracotomies, etc. Definitely a great place to train and work, wouldn't mind practicing here when I finish fellowship.

 

[Mary Jane Watson]

I hear that Vandy has an excellent student rotation - a friend of mine did it last year and he said the teaching was outstanding. As an added bonus, he said that his letter from there got him a lot of big interviews.

MJ